lung nodule

A 45-year-old male presents with a 3-month history of cough and unintentional weight loss. He is a former smoker. Physical examination is unremarkable. A chest X-ray showed a nodule, and a PET-CT was performed for further characterisation, an axial view is shown. Considering the imaging findings and clinical presentation, what is the MOST appropriate next diagnostic step?

A 72-year-old retired builder with a 50 pack-year smoking history presents with a 3-month history of worsening cough, occasional streaks of blood in sputum, and unintentional weight loss of 6 kg. He reports mild dyspnoea on exertion, able to climb one flight of stairs before needing to rest. On examination, he is thin but alert, with an ECOG performance status of 1. Chest auscultation reveals decreased breath sounds over the right upper zone. A chest X-ray shows a 4.5 cm spiculated mass in the right upper lobe. There is no obvious pleural effusion or mediastinal widening. Full blood count, electrolytes, liver function tests, and renal function tests are within normal limits, except for a haemoglobin of 115 g/L. Spirometry shows FEV1 65% predicted, FVC 80% predicted, FEV1/FVC ratio 0.7.

A 58-year-old non-smoker presents with a 4-month history of intermittent fever, night sweats, and a persistent cough productive of small amounts of sputum. He recently emigrated from a region with a high prevalence of tuberculosis. Physical examination is unremarkable. Chest X-ray reveals a solitary nodule in the right upper lobe. A PET-CT scan is performed as part of the investigation. Considering the findings demonstrated in the image provided in the context of this patient's presentation, which of the following is the most appropriate next step in the management of this patient?

A 65-year-old patient with a history of smoking presents with a chronic cough and mild weight loss over three months. Physical examination is unremarkable, and vital signs are stable. Routine blood tests, including full blood count and inflammatory markers, are within normal limits. A chest X-ray revealed a solitary pulmonary nodule in the right upper lobe. Subsequent PET-CT imaging was performed as part of the diagnostic workup. Considering the findings demonstrated in the image provided in the context of this patient's presentation, which of the following is the most appropriate next step in the management of this patient?